The Convergence of Neurology and Psychiatry

Keshavan, Matcheri S.; Price, Bruce H.; Martin, Joseph B.

doi:10.1001/jama.2020.0062

Cited by 30 publications

(25 citation statements)

References 9 publications

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“…3 When polled in 2015, less than half of neurology graduates who responded were satisfied with their psychiatric training—highlighting the need for increased collaboration between neurology and psychiatry to promote a more integrated neuropsychiatric approach to patient care. 4 5 6 7 8…”

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confidence: 99%

Psychotherapeutic Tools to Enhance the Neurologist-Patient Interaction

DeGrush

LaFrance

2022

Semin Neurol

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Despite providing care for patients with “disturbances of the same organ,” the brain, the therapeutic approaches used by neurologists and psychiatrists are, to some extent, distinct. With recognition of the closely coupled relationship between physical health and mental health, there is increased awareness of the need to provide an integrated, neuropsychiatric approach to the care of patients in neurology. In this review article, we provide a broad overview of how neurologists can use psychotherapeutic principles to enhance patient–physician interactions in the neurological setting (e.g., developing a therapeutic alliance; frame/boundary setting; active, empathic listening; acknowledging affect). These practices relate to a broad range of conditions, including, but not necessarily limited to epilepsy, traumatic brain injury, and functional neurological (conversion) disorder. The authors provide practical approaches that a neurologist can learn to leverage psychotherapeutic tools to enhance clinical encounters.

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Section: Tablementioning

confidence: 99%

Psychotherapeutic Tools to Enhance the Neurologist-Patient Interaction

DeGrush

LaFrance

2022

Semin Neurol

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“…In this perspective article, we aim to increase cross-talk between the clinical neurosciences by detailing how a patient-centered, biopsychosocial formulation can serve as a guide for precision medicine in neurology. 10 11 12 In this endeavor, we briefly explain the evolution of clinical precision medicine, the “mechanics” of the biopsychosocial model, and provide examples of the use of the biopsychosocial formulation to guide longitudinal care in several neurological conditions.…”

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confidence: 99%

Using the Biopsychosocial Model to Guide Patient-Centered Neurological Treatments

et al. 2022

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The biopsychosocial model was defined by George L. Engel to propose a holistic approach to patient care. Through this model, physicians can understand patients in their context to aid the development of tailored, individualized treatment plans that consider relevant biological, psychological, and social–cultural–spiritual factors impacting health and longitudinal care. In this article, we advocate for the use of the biopsychosocial model in neurology practice across outpatient and inpatient clinical settings. To do so, we first present the history of the biopsychosocial model, and its relationships to precision medicine and deep phenotyping. Then, we bring the neurologist up-to-date information on the components of the biopsychosocial clinical formulation, including predisposing, precipitating, perpetuating, and protective factors. We conclude by detailing illustrative neurological case examples using the biopsychosocial model, emphasizing the importance of considering relevant psychological and social factors to aid the delivery of patient-centered clinical care in neurology.

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“…resembling stroke, epileptic seizures), yet etiologically shares similarities with mental health disorders. The time is now to challenge the stigma associated with psychiatric disorders and break down the walls that divide mental health and physical health in society (Keshavan et al, 2020).…”

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confidence: 99%

“…What is the path forward? We join like-minded colleagues encouraging a greater collaboration across psychiatry and neurology as the way to facilitate enhanced participation of psychiatry in FND-related efforts (Keshavan et al, 2020). Psychiatry and neurology remain separate disciplines and, in many countries, neuropsychiatric training does not exist.…”

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confidence: 99%

“…The psychiatric perspective is critically important to FND patient-care and research. With the DSM-5 inclusion of examination signs, psychiatrists need more neurology training to be involved in the early phases of the FND diagnostic process (Keshavan, Price, & Martin, 2020). However, diagnosis based solely on rule-in signs does NOT equal a comprehensive patient-centered treatment plan.…”

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confidence: 99%

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